The US President is pressing the Secretary of Health and Human Services to make deeper cuts to the country's routine childhood immunisation schedule, according to officials familiar with internal discussions. The push stems from the President's long-held view, unsupported by scientific evidence, that vaccines are linked to autism, an issue he has described as central to his legacy in office. The renewed pressure comes as the administration navigates opposition from paediatricians, ongoing federal litigation, and political advisers who see the issue as a liability heading into the midterms.

Within the administration, the vaccine question has become a source of friction. Internal polling has reportedly warned that policies seen as hostile to vaccination carry political risk among suburban and independent voters, groups the party needs to hold seats in next year's elections. Senior political strategists had previously set a year-end deadline for any further changes to public health policy, on the reasoning that doing so would allow the controversy to recede before campaigning intensifies.

The President has not been persuaded by that caution. He has recently questioned why the Health Secretary has not moved further or faster, according to people briefed on the exchanges, suggesting the cuts made so far do not go far enough to satisfy his ambitions on the issue.

Those cuts have already reshaped federal vaccine guidance. The Health Secretary oversaw a reduction in the recommended childhood immunisation schedule by roughly a third, an unprecedented step for a federal health agency. A federal judge subsequently halted parts of the changes after a lawsuit brought by major paediatric associations, and paused the work of a new vaccine advisory committee the Secretary had established. The administration has since sought other routes around the ruling. The President issued an executive order urging further revisions to the schedule, while the Health Secretary has moved to redirect billions of dollars in federal research funding toward studies examining a link between vaccines and autism that has been repeatedly disproven.

The dispute is unfolding against a deteriorating public health picture. The United States is recording its highest rate of measles infections in three decades, and deaths linked to whooping cough, influenza and tetanus have been rising. Decades of research have established genetics as the principal driver of autism, and numerous large-scale studies have found no causal connection between vaccination and the condition. That scientific consensus has not shifted despite the renewed political attention on the issue.

White House and health department officials defend the changes as a response to concerns from parents that they say have gone unaddressed for years. They describe the funding redirected toward autism research as evidence-based inquiry into rising rates of chronic illness in children, rather than a retreat from established science.

Infectious disease specialists and paediatricians have been sharply critical of that framing. Several have warned that the administration's approach risks being remembered for the return of diseases that vaccination had all but eliminated in the United States, rather than for any medical advance. They point to the resurgence of measles and the rising toll from whooping cough as early evidence of what sustained reductions in vaccine coverage can produce.

Legal challenges to the schedule changes remain before the courts, with further rulings expected in the coming months. The administration has given no sign of abandoning its approach in the meantime, and the President's continued pressure on the Health Secretary suggests the disagreement between political caution and personal conviction is unlikely to be resolved before the public health consequences become clearer.

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